ABSTRACT

To determine the incidence of diabetic microvascular complications (retinopathy, nephropathy, and neuropathy) and their association with osteomyelitis.

A retrospective analysis of 52 patients, followed at the Endocrinology and Metabolism Department of Gazi University Hospital, was carried out. Demographic data, age, duration of diabetes, HbA1c levels, serum creatinine, 24-hour albumin excretion, fundoscopic examination and monofilament test results were recorded for each patient. Diabetic foot ulcers were classified according to the Wagner classification, and MRI and bone scintigraphy were instituted according to each patient’s class.

Of the 52 patients with diabetic foot ulcers, 27 (51.9%) were female and 25 (48.1%) were male, with a mean age of 57.32±12.6 years in the study group; the mean duration of diabetes and HbA1c level were 16.63±8.2 years and 8.94±1.87%, respectively. 63.5% of the patients had nephropathy at different stages, 86.3% had proliferative or nonproliferative retinopathy, and 92.3% had peripheral polyneuropathy. MRI or scintigraphy was required in 44 patients out of the 52, and 23 of these 44 (52.3%) were diagnosed with osteomyelitis. 100% of the patients with osteomyelitis had neuropathy, 65.2% had nephropathy, and 87% had retinopathy; the percentages were 90.5%, 66.7%, and 85% for patients without osteomyelitis, respectively

Diabetic foot is an important complication of diabetes mellitus and osteomyelitis is a grave clinical picture in this setting. Since diabetic microvascular complications are very frequently encountered in those patients, every patient should be carefully evaluated for the presence of micro-angiopathy when they suffer from diabetic foot.